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Experimental knee pain impairs postural stability during quiet stance but not after perturbations

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Abstract

The objective of this study was to examine the effect of experimental knee-related pain on postural control. Twelve healthy subjects stood as quietly as possible on a movable force platform (that measured the centre of pressure and provided fast perturbations) before, during, and after experimental knee-related pain. Lower limb electromyographic (EMG) activity and joint angles were measured. Experimental pain was induced by injecting hypertonic saline into the infrapatellar fat pad (unilateral and bilateral) and isotonic saline was used for control sessions. Compared with the baseline and control sessions, unilateral and bilateral knee-related pain during quiet standing evoked (1) an increased sway displacement in the anterior–posterior direction (P < 0.05), (2) larger knee flexion (P < 0.05), and (3) larger EMG changes. Bilateral pain also induced (1) larger medial–lateral sway displacement and speed (P < 0.05) and (2) larger left hip flexion (P < 0.05). During forward perturbations, subjects leaned forward during both painful conditions when compared with baseline (P < 0.05). The additional impairment by bilateral pain suggests that the non-painful limb in unilateral pain conditions compensates for the impaired postural control. These results show that knee-related pain impairs postural stability during quiet standing, indicating the vulnerability of patients with knee pain to falls. This measure could potentially help clinicians who seek to assess how pain responses may contribute to patient’s postural control and stability during quiet standing.

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Acknowledgments

We thank the Danish Arthritis Association and the Danish Ministry of Health and Prevention for supporting this study and Hongling Nie, MD, PhD, for performing the injections.

Conflict of interest

There is no conflict of interest related to this study.

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Authors and Affiliations

  1. Laboratory for Musculoskeletal Pain and Motor Control, Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), Aalborg University, Fredrik Bajers Vej 7D-3, 9220, Aalborg, Denmark

    Rogério Pessoto Hirata, Lars Arendt-Nielsen, Shinichiro Shiozawa & Thomas Graven-Nielsen

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  1. Rogério Pessoto Hirata
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  2. Lars Arendt-Nielsen
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  3. Shinichiro Shiozawa
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  4. Thomas Graven-Nielsen
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Correspondence to Thomas Graven-Nielsen.

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Communicated by Fausto Baldissera.

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Hirata, R.P., Arendt-Nielsen, L., Shiozawa, S. et al. Experimental knee pain impairs postural stability during quiet stance but not after perturbations. Eur J Appl Physiol 112, 2511–2521 (2012). https://doi.org/10.1007/s00421-011-2226-3

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  • DOI: https://doi.org/10.1007/s00421-011-2226-3

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